Provider Demographics
NPI:1285850487
Name:HILL, STEPHEN JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAY
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7533
Mailing Address - Country:US
Mailing Address - Phone:480-897-1788
Mailing Address - Fax:480-897-0076
Practice Address - Street 1:2143 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7533
Practice Address - Country:US
Practice Address - Phone:480-897-1788
Practice Address - Fax:480-897-0076
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZXT18072Medicare UPIN